Well-baby exam: What to expect during routine checkups

Well-baby exams, or regular checkups, are an important way to monitor your baby's growth and development. These exams also provide an opportunity to develop a relationship with your baby's doctor.

Your baby's doctor will likely recommend the first well-baby exam within three to five days after birth, or shortly after you're discharged from the hospital. Additional well-baby exams will be needed every few weeks and, later, months for the first year. In some cases, the baby's doctor might want more frequent checkups. Here's what's on the agenda during these exams.

Your baby's measurements

A well-baby exam usually begins with measurements. You'll need to undress your baby so he or she can be accurately weighed on an infant scale. Length will be measured by placing your baby on a flat surface and stretching his or her legs out. A special tape will be used to measure his or her head circumference.

The measurements will be plotted on a growth chart to determine your baby's growth curve. This will help determine if your baby is growing normally and show how his or her growth compares to other children of the same age.

Head-to-toe physical exam

Expect a thorough physical exam during the checkup. Mention any concerns you have or areas you want the doctor to check out. Here are the basics:

Head. The doctor will check the soft spots (fontanels) on your baby's head. These gaps between the skull bones are safe to touch and give your baby's brain room to grow. The doctor will check the shape of your baby's head as well.

Ears. The doctor will check for fluid or infection in your baby's ears with an instrument called an otoscope. He or she might observe your baby's response to various sounds, including your voice.

Eyes. He or she might also look inside your baby's eyes with an instrument called an ophthalmoscope. As your baby gets older, the doctor might use a bright object or flashlight to catch your baby's attention and then track your baby's eye movements.

Mouth. A look inside your baby's mouth might reveal signs of oral thrush, a common — and easily treated — yeast infection. As your baby gets older, the doctor might ask whether you've noticed more drooling or chewing than usual. These are often the first signs of teething.

Skin. Various skin conditions might be identified during the exam, including birthmarks and rashes.

Heart and lungs. The doctor will listen to your baby's heart and lungs with a stethoscope to detect any abnormal heart sounds or rhythms or breathing difficulties. Heart murmurs are often innocent, yet sometimes consultation with a specialist is recommended.

Abdomen. By gently pressing your baby's abdomen, the doctor can detect tenderness, enlarged organs or an umbilical hernia, which occurs when a bit of intestine or fatty tissue near the navel breaks through the muscular wall of the abdomen.

Hips and legs. The doctor might move your baby's legs to check for dislocation or other problems with the hip joints.

Genitalia. The doctor will likely inspect your baby's genitalia for tenderness, lumps or other signs of infection. For girls, the doctor might ask about vaginal discharge. For boys, the doctor will make sure both testes have descended into the scrotum and, in the case of circumcision, whether the penis is healing properly.

Unless your baby has special needs or concerns, lab tests aren't needed at most well-baby exams.

Your baby's development

Your baby's motor skills and development are important, too. Depending on your baby's age, be prepared to answer questions like these:

How well does your baby control his or her head?

Does your baby imitate your facial expressions and sounds?

Does your baby reach for objects or put them into his or her mouth?

Does your baby attempt to roll over?

Can your baby sit with support?

Does your baby pull up into a standing position?

Does your baby use individual fingers to pick up small objects?

Your baby's vaccines

Your baby will need various vaccines at well-baby visits. During each injection, the doctor will instruct you on how to hold your baby and help keep him or her still. Afterward, hold your baby, talk, sing, breast-feed or offer your baby a bottle to help soothe him or her.

Time to talk

During the appointment, your baby's doctor will likely ask how things are going. Be ready to describe a typical day with your baby. For example:

How many hours does your baby sleep during the day? At night?

How often do you feed your baby? If you're breast-feeding, are you having any trouble?

How many diapers does your baby wet and soil in a day?

How active is your baby?

Are you including tummy time in your baby's activities?

How is your baby's temperament?

In addition, your baby's doctor might ask questions about your family's home life and medical history. The doctor might also discuss safety issues, such as placing your baby to sleep on his or her back and using a rear-facing infant car seat. Although breast milk or formula will be the main part of your baby's diet throughout the first year, you'll also talk about when to introduce solid foods.

Undoubtedly, you'll have questions, too. Ask away! Consider writing down your questions beforehand so you don't forget them in the moment. If you and your partner can't both attend the visit, ask a relative or friend to come with you to help care for your baby while you talk to the doctor.

Also remember your own health. If you're feeling depressed, stressed out or run-down, describe what's happening. Your baby's doctor is there to help you, too.

Heading home

Make sure you know when to schedule your baby's next appointment — and how to reach the doctor in the meantime. Ask if the doctor's office or clinic offers a 24-hour nurse information service. Knowing help is available when you need it can offer peace of mind.

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